Insurance Plans November 2, 2020

We are living in a world where a health emergency can come anytime without any prior information. Costly hospital bills can get your finances in jeopardy. That’s why a large number of people are choosing a Health Insurance Plan. A Health Insurance Plan makes sure that you don’t need to bear any expenses in case any unfortunate medical emergency happens. United India Insurance Company is one of the leading and oldest Insurance Companies working in India that provides different insurance Plans – Platinum, Gold and Senior Citizen. Here, we will discuss the United India Platinum Insurance Plan, which is designed for customers aged 18 to 35 years.

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United India Platinum Insurance Plan provides a higher sum insured to customers with additional features like Free Health Check-up and Coverage of Children from the age of 91 days. So, what are its prominent features? Here, we will cover this and what this Health Insurance Plan will cover, Claim procedure, Required Documents, etc. So, keep reading!

United India Platinum Insurance Plan Features

United India Platinum Insurance Plan offers medical coverage to individuals based on Individual sum insured. But if you want to opt for this policy on a Family Package basis, you can opt for it too. With a Family Policy, each individual of the family, such as Prosper, Spouse, Dependent Children, and Parents will get an insured sum. We are showing some of the prominent features of the United India Platinum Insurance Plan below. Have a look!

  1. Any person having an age of 18 to 35 years can opt for this Insurance Plan for himself/herself and his/ her family. The family members can be Self, Spouse, Dependent Children, and Parents. Each individual will have an individual sum insured for himself/ herself.
  2. With the Platinum Plan, an individual can have different Sum Insured options of INR 2 lakh, INR 3 lakh, INR 5 lakh, INR 8 lakh, INR 10 lakh, INR 15 lakh and INR 20 lakh to choose from.
  3. Children above the age of 3 months and below 18 years will also get coverage under the Insurance Plan if either or both parents have a United India Platinum Insurance Plan. Children above 18 years of age will also get coverage if they are unmarried/ unemployed and dependent on parents.
  4. If you renew your policy without any break, you can continue to enjoy the features of the Platinum Plan even after crossing the maximum age. So, even if you are 36 years old but have been paying the premium without any break, you will be in Platinum Plan.
  5. A newly married spouse can get inclusion as a family member in the Platinum Plan within 60 days of Marriage. On the other hand, newborn babies (between the age of 91 days to 180 days) can also be included. In this case, the mother should be insured under the Platinum Plan.
  6. The overall term of the Policy will be a maximum of 1 year. After this period, you will need to renew the policy.

United India Platinum Insurance Plan Coverage Details: What does it Cover?

When going for any Health Insurance Plan, it is important to know the coverage of your policy. So, what does the United Platinum Insurance Plan cover? We are showing it below. Do check!

  1. In-patient Hospitalization Expenses Cover ( Room, Boarding & Nursery expenses, Fees of Medical Practitioner/ Surgeon/ Specialists, All Hospitalization expenses excluding the Cost of Organ, Operation Theatre Charges, etc.)
  2. Other expenses such as Dental Treatment & Plastic Surgery necessitated due to Injury or Disease and All Day Care Treatment
  3. Pre-hospitalization medical expenses up to 30 days before hospitalization
  4. Post-hospitalization medical expenses up to 60 days after discharge from the hospital.
  5. Domiciliary Hospitalization on a reimbursement basis for a period exceeding three days (However, it will not cover diseases like Asthma, Bronchitis, Epilepsy, Hypertension, etc.)
  6. Ayurvedic Treatment
  7. Modern Treatment Methods & Advancement in Technologies (Limits per surgery will vary according to the modern treatment methods)
  8. Cost of Health check-up up to 1% of the Average Sum Insured of the last three claim-free years (Subject to a maximum of INR 5,000 per individual per policy period)
  9. Optional Covers like Road Ambulance Cover up to INR 2,500 per person per policy period on transportation of the individual.
  10. Daily Cash Allowance for every continuous 24 hours of Hospitalization (maximum of INR 5,000 per policy period by paying an additional premium of INR 300)

Exclusions from United India Platinum Insurance Plan

Now you know everything about the coverage of the United India Platinum Insurance Plan, you should also the exclusions – what does it not cover? The best thing about the Platinum Plan is the absence of the Waiting Period that is necessary for Gold and Senior Citizen Plans. We are showing all the things that the Platinum Plan does not cover. Please check!

  1. Expenses caused by Foreign Invasions, Act of Foreign Enemies, Warlike Operations, Civil War, etc.
  2. Stem Cell Implantation/ Surgery, Harvesting, Storage, etc.
  3. Any Expenses related to Sterility and infertility
  4. Medical Treatments related to Maternity
  5. Cosmetic or Plastic Surgery
  6. Change of Gender-treatments
  7. Obesity/ Weight Control
  8. Intentional Self-inflicted Injury
  9. Treatments other than Allopathic and Ayurvedic Branches of Medicine
  10. Rest Cure, Rehabilitation and Respite Care
  11. Cost of hearing aids, Routine Eye-examination Expenses, cost of spectacles, etc.
  12. Medical expenses related to Unproven Treatments

How to Get a Claim for United India Platinum Insurance Plan?

Now you would want to know how you can get Claim for your United India Platinum Insurance Plan. If a medical emergency happens and is under the Claim, the Insured person or its representatives will need to inform the TPA or Company (depending upon who will process the claim).

For this, you will need to provide all the information related to the Claim, such as Plan of Treatment, Policy Number, etc, within a fixed time frame. In the case of Emergency Hospitalization, this time limit is within 24 hours from the date of hospitalization or before the discharge from the hospital, while in the case of planned hospitalization, you should inform at least 48 hours before the hospitalization. United India provides Claim for your policy via both Cashless and Reimbursement methods. Want to know the procedure? We are showing it below. Do check!

Cashless Claim Procedure by the TPA

  1. The first step you will need to do is to intimate your Claim. For this, you will need to call the TPA’s free toll-free number. You will also need to inform about your ID number on your Health Card.
  2. When admitted to the Network Hospital or PPN Hospital, you will need to show your ID Card issued by the TPA. The hospital will complete the cashless Request Form and send it to the TPA.
  3. After getting the request form and medical information, TPA will verify the details and issue the pre-authorization letter to the hospital.
  4. The insured person will need to sign and verify the discharge papers at the time of discharge.
  5. Remember, the TPA can deny providing a pre-authorization letter on not receiving the required medical information. Do not consider this denial as a denial of treatment or denial of coverage in any way. You can get the reimbursement by submitting the claim documents later.

Reimbursement Claims Procedure

  1. If you are getting admitted to a non-network hospital, you will need to make the payments upfront. After making the payment, you will need to submit the necessary documents to the TPA for reimbursement within the pre-decided time limit (within 15 days from the date of discharge).
  2. The request for pre-hospitalization and post-hospitalization will be settled according to the relevant claim documents and cash receipts within a certain period (within 15 days from completion of post-hospitalization treatment). United India will verify them and reimburse the amount.
  3. For any claims related to the Health Check-ups, you will need to submit the test reports and cash receipts within a fixed period. This period is within 15 days from the Health check-up.

Required Documents for Reimbursement Claims Procedure

As we said earlier, the insured person will need to submit a few documents to get the claims for United India Platinum Insurance Plan via the Reimbursement method. So what are these documents? We are showing the same below. Have a look!

  1. Duly filled Claim Form
  2. Certificate of Diagnosis/ Nature of Operation performed from the treating Medical Practitioner/ Surgeon along with Date of Diagnosis, Advice for admission, etc.
  3. Medical History of patients, Bills, Payment receipts along with the prescription of attending medical practitioner/ hospital
  4. Discharge Certificate from the Hospital
  5. Payment Receipts from treating doctors, surgeons and anesthetist
  6. Bills, receipt and stickers of the Implants (if any)
  7. Any other required documents asked by the TPA/ Company

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